J.Jpn. Surg. Soc.
ISSN 1880-1129

[Abstract] [Full Text PDF] （in Japanese / 9083KB） [Members Only And Two Factor Auth.]

J.Jpn. Surg. Soc.. 60(2): 315-325, 1959

STUDY ON THE SURGICAL APPLICATION OF THE HIGH INTENSITY FOCUSED ULTRASOUND
(PART 1.) APPLICATION FOR THE SELECTIVE LOCALIZED DESTRUCTION OF THE CENTRAL NERVOUS SYSTEM

1) Department of Surgery, Osaka University Branch Hospital (Director : Dr. Oka)
2) First Department of Surgery, Osaka University Medical School (Director: Prof. Ozawa)
3) Ultrasonics Department, Institute of Scientific and Industrial Research, Osaka University (Director: Prof. Yoshioka)

Masuhisa OKA1), Takashi OKUMURA1), Shoichi OKUNO1), Nobuo OKU1), Hiromu YOKOI2), Tsuneji MURAO2), Yasuo MIYASHITA2), Kozo OTA2), Totaro HIRATA2), Katsuya YOSHIOKA3), Hideyuki HIRANO3), Michiya KAWASHIMA3)

The authors have already obtained the conclusions on the therapeutic use of the ultrasound as well as on the influences upon the nervous system (to be published on the American Journal of Physical Medicine and Psychiatria et Neurologia Japonica and so forth) .
When the intensified ultrasound is used irradiated cells are destroyed and change in various degenerative processes. It is only possible by using the focussing method of the sound to localize the ultrasonic destruction in a certain small portion. On the focal region of the sound there appear a small localized and very intesive sound field, in which the destructive action can also be easily obtained.
This small focal region can be located in a desired site by the stereotaxic apparatus. Therefore, various stereotaxic surgical operations can be performed by the focused ultrasound of hige intensity.
The apparatus used consists of the sound lens of polystylene or acrylite, overlaid by a quartz plate vibrator, whose sound frequency being 1.46 MC and the focal length of the lens used is 9 cm. The focal region shows long oval shape, whose longitudinal axis is parallel to the sound beam. In the focal region where the ultrasound energy is concentrated very accurately localized histological degeneration can be found in an area of 3 × 3 × 6 mm by irradiating in the mean focal intensity of 170 W/sqcm. Maximal intensity in the focal region is approximately equal to that multiplied 4.4 to the mean focal intensity,
By means of controling the irradiation time we can make the destructions of various degrees. For the zero point of the stereotaxic apparatus we use the crossing point of the sagittal and coronary sutute line, as well as the middle point between openings of the external auditory meatus on both sides. After ultrasonic irradiation for 1-5 secs. through the skull opening of the cat without incising the dura, we have observed the histological specimens and have found no vascular lesions. Immediately after the irradiation no macroscopic changes can be seen, but on the specimen taken after about ten hours or more there appears a clearly oval shaped focal destruction. By the irradiation within 2 secs. the reversible changes occur.
Three patients were irradiated by the focused high intensity ultrasound after the first operation on July, last year. Our experiences are the focal destructions of the white matter in the prefrontal lobe and in the large areas of the hemisphere, and the partial thalamic destruction, as substitutes of lobotomy and hemispherectomy.
Spike foci disappeared after the focal destructions and the lateral ventricles showed the localized enlargement, coincided to the ultrasonic destructions. The postoperative courses of the patients irradiated were as those of the simple craniotomy, their violent symptoms being diminished.
The ultrasonic small focal destruction of the central nervous system may be very useful for various surgical interventions and the neurological studies.
(authors' abstruct)

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